While the overall cancer death rate in African Americans has continued to decline since the early 1990s, the rate is still 35 percent higher for African American men and 18 percent higher for African American women than for white men and white women, according to a recent report by the American Cancer Society. Minority Cancer Awareness Week (April 15-21) is designed to raise awareness about this health disparity and the need to improve prevention and early detection efforts. Cancer is second only to cardiovascular disease as the leading cause of death among Americans. One in four deaths in the United States is attributable to cancer and one in three Americans will eventually develop some form of cancer. Although cancer is common in Americans of all racial and ethnic groups, the cancer rate varies considerably from group to group, according to the American Cancer Society. Among men, cancer rates are highest among African Americans followed by whites. Cancer rates among Asian men - in particular Chinese, Filipinos, and Koreans - are low. Among women, the differences in rates across racial and ethnic groups are less pronounced than among men. Rates are highest among Alaska-Native women followed closely by whites. However, while African American women are less likely to get breast cancer than white women, they are more likely to die from it. "We don't know as much about these health disparities as we would like," said Dr. Michael Bastasch, a radiation oncologist on the medical staff at Washington Hospital. "There are multiple environmental and genetic factors that determine whether someone will get cancer." The most likely causes seem to be related to socioeconomic factors and lifestyle choices. For example, smoking is more common in African American men than white men and being overweight or obese, which raises the risk of many cancers, is more common in African American women than white women. Lack of access to health care most certainly plays a role in higher cancer death rates in African Americans. Statistics provided by the American Cancer Society are alarming:* African Americans have the highest death rate of any racial and ethnic group for all cancers combined and for most major cancers.* Death rates from prostate cancer are 2.4 times higher in African American men compared to white men.* Breast cancer death rates are 1.4 times higher among African American women than white women.* Although death rates are declining for colorectal cancer and breast cancer among both African Americans and whites, declines are smaller for African Americans resulting in widening disparities.* African Americans are more likely to be diagnosed at a later stage when there are fewer and less effective treatment options.Prevention and Early Detection Are Key Inequalities in education, income, and health insurance coverage, as well as social barriers to high-quality cancer prevention, early detection, and treatment contribute to lower five-year cancer survival rates for African Americans compared to whites, according to the American Cancer Society. At least half of all cancer deaths in this country could be avoided if we all did what is needed to prevent disease, including staying away from tobacco, maintaining a healthy weight, eating a nutritious diet, increasing physical activity and getting regular screening tests. However, socioeconomic factors make this more difficult for some. Screenings such as prostate-specific antigen (PSA) tests for prostrate cancer and mammograms for breast cancer literally save lives, but they are expensive. Without regular screenings, the chances of detecting cancer in the early stages - when it is most treatable - are drastically reduced. For some cancers, early detection actually prevents the onset of disease. For example, a colonoscopy can detect an abnormal growth of tissue, called a polyp, inside the colon before it becomes cancerous. "Diet, exercise and lifestyle choices play a key role in the development of cancer," Dr. Bastasch said. "But you also need to visit a physician and get regular screenings. Prevention is linked to early detection." To learn more about cancer prevention and early detection, visit www.cancer.org. For more information about Washington Hospital's programs and services, including the Washington Radiation Oncology Center and Washington Women's Center, visit www.whhs.com.